Provider Demographics
NPI:1770828923
Name:TERZIAN, RAFFI BEDROS (PHD)
Entity Type:Individual
Prefix:DR
First Name:RAFFI
Middle Name:BEDROS
Last Name:TERZIAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8060 258TH ST
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1234
Mailing Address - Country:US
Mailing Address - Phone:508-615-1967
Mailing Address - Fax:
Practice Address - Street 1:512 7TH AVE
Practice Address - Street 2:14TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-4603
Practice Address - Country:US
Practice Address - Phone:212-768-7979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035645-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist